Laserfiche WebLink
f <br /> Ultramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No Sampler(Print Name) Date Form No <br /> 6 q I ANALYSES Z Q of <br /> Project No �tYY S <br /> amr ig ature) <br /> q1, llCD <br /> eu <br /> Project Location c = (� U ✓ <br /> o M ,f� <br /> I CJ f Q•v d� O X rn v O f✓ / <br /> w2 0 <br /> Sample NoAdentlficatlon Date Time Lab No m a CL z REMARKS <br /> if <br /> VA <br /> 15- <br /> G <br /> -- ME I - If <br /> ^ w rL <br /> elinquished by (Signal e/Affiliation) Date Time Received by (Signalur filiation) Date Time <br /> /-rrad tuO, T <br /> Re nquis b (Signatu Affilhation) Date ime Receiv by (Signatbrewiliation) Date Time <br /> Relinqhed by (Sig ature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> Report To ,n Bill to ULTRAMAR INC <br /> �. 0"r y /E; �,r-l(•�v� 525 West Third Street <br /> 11 `' Hanford, CA 932 <br /> Ho^ Z Ort/ Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 32 W03 IM <br />